GOVERNMENTMedicare rural bonus payments left unclaimedPhysicians are unaware of the funds and confused about eligibility.By Markian Hawryluk, amednews staff. Aug. 4, 2003. Washington -- Physicians providing Medicare services in underserved areas are not claiming bonus payments available to them, according to a recent study by Rand, a nonprofit research group. The findings come at a time when rural physicians are complaining that Medicare is shortchanging them. But even doctors who are aware of the bonus program struggle to determine whether they are eligible. That has left Medicare's primary means of protecting the rural health care safety net largely ineffective. The study found that bonus payments rose substantially in the first half of the 1990s but had begun to decline by 1998, the latest year for which data were available. The analysis was done for the Centers for Medicare & Medicaid Services and published in the July/August Health Affairs. "We found that a lot of physicians who could be collecting the payments aren't asking for them," said Lisa Shugarman, the study's lead researcher. "We don't know why. They may not be aware they qualify, the paperwork may be onerous, or they may be concerned about being audited." The payments were established by Congress in 1987 to retain physicians in underserved areas and to attract new ones. The program provides a 10% increase in Medicare rates for services provided to beneficiaries in health professional shortage areas. These areas, designated by the Health Resources and Services Administration, must have less than one primary care doctor per 3,500 people, must be rational locations for primary care delivery and must have primary care work forces that are overutilized or far from the patient population. In 1997, 64% of nonmetropolitan counties included at least one shortage area, and about 10% had no active primary care physician. Neither the doctor nor the patient need to reside in the shortage area, but the service must be provided within that boundary. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2003 American Medical Association. All rights reserved.
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The doctors are in the house
The AMA's House of Delegates is holding its Interim Meeting Nov. 7-10 in Houston, addressing issues such as health system reform and physician payment. Meeting coverage - Slideshow Feature articlesHealth reform review The Massachusetts experience Litigation stress Being sued is personal as well as professional Comprehensive coverage
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